Loading...
Permit A CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2009 -00327 13 125 SW Ha ll Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/30/2009 TIGARD Parcel: 2S 111 C D 10300 Jurisdiction: Tigard Site address: 9830 SW KIMBERLY DR Subdivision: Lot: 0 Project: Wegener Project Description: 2 branch circuits for A/C & work plug. Owner: FEES WEGENER, BRIAN AND Quantity Description Date Amount KAREN BULLARD, 9830 SW KIMBERLY TIGARD, OR 97223 2 crt Branch Circuits 06/30/2009 $53.50 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 06/30/2009 $6.42 Electrical Contractor: CANBY ELECTRIC INC 790 S IVY ST CANBY, OR 97013 PHONE: 503 - 266 -7878 FAX: 503- 266 -5543 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $59.92 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law - quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 95 -A p0.You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: 0---PA- / i OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. EIe Permit , ,) • City of Tigard Received I� tit / Perm No . — L L — . ".,, 13125 SW Hall Rlvd. Ti rd OR 97 2 � d. e n P� � � Plan Review •6 Pho either Permit. Phone 503,639.4171 Fax 503,598.196 0 �UN 3 0 2009 gate /Ey: T I c, A.R. n Inspection l lnc: 50.3 639 4175 Date Ready /By' 1,. n ® Sec Puye 2 for Inspection : www,tigard- or.gov Notified/method: � _ _ supps_me :,sal information • TYPE OF'WO � PLAN REVIEW ._.___ blft - ❑ New coFlStnrcfl6n Addition/alter Cnt Please asc check all tha apply (subuw 2 un of plans w /imnu checked below)' 1:l Service or feeder 400 amps or mare ❑ nuddmg over three stories. 0 Demolition ❑ Other: where the available fault current ID Marin;u anti boatyards.. CATEGORY OF CONSI'K J K'ION exceeds :0,000 stops as 150 volls or F,3 rioatln Im Id ii . . less to broond, or exceeds 1x.00(1 C7 C Untmerc, il se'aricuhural - and 2- family dwelling [) Commercial/industrial ❑Accessory building amps for nu pike tnsiallaliim;. buildings ❑ Multt-t3mily ❑ Master builder ❑ Other:, ❑Firc pump. ❑ 1 oiallation of '75 KVAor' larger srp,u.tlely derives system: JOB SITE IN ORMATIO ANO'.LOC,�TION ©A dd i tion of new motor load of ,-f— Yy . J"' • �„ 100111 Or uwtc c. .u��y. Job'no.: Ji >ls titt0 Sddfe.SS: �� ❑ Si x or m ore reradcnonl unlr U R cr vehicle barks C.il','/SIntel %1P /y y ��7 �1 ❑ Ilealttt Care facll U :opal} ,ultal c for more tit 7- / L El a u u. 1,00 ooh >' n otioil Hnzttrdor fu c 1 :, Suitt /bldg, /apt- no. Project name: 0 Sr.rvxc o, feeder 600 wrtpR ter 11101.e. J - rrr�r`l... SCHEDULE :, .._ •w. -.— `Cross s PEE sci troeUdireclions to job site: owcelpt ou _ ' _ i I I'm = • 'rood New residenti single- or ntulii- family dwelling unit. . Includes attached garage. Subdivision: Lot no.. 1,000 sq. It or loss i4i 15 , .: L:a. add') 500 sq. ft or portion 3340 ax t p. pare�;1 no.: limited energy residential 7.5.00 na DESCRIPTION _ OF WORK • ., 1 (with atx ee SQ. tt) . J L m a ion, arts: /or'relocetion 200 a mps or less r TNANTi 201 amps to 400 aon i 1 0(.85 ❑ PROPERTY OWNER C7'.E . -.... _ ,,._. N e 401 amps to 600 amps 160.60 am G�YI Q �„ 601 snips to 1,000 am ps :40.60 _ 2 ' Addres:' Over 1,000 amps or volts L...,. 454.65 ' • ! 2 C ity7Siate /ZIP. Temporary services or feeders installation, alteration, and /or • • -. relocation z I . . 6685 I • ' '. ' Phone: :565) L` J•) 6 . 1 - 1 I f I .. Fax: ( ) 2 amps s to ago a,nps —.... 100 ;i) , z Owner installation: 'ibis installation is being made on property thin 1 own which is not mt p - 401, amps to 599 amps ; 1 33.75 2 intended for sale, lease. rent. or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Ow'ner,signature: Dater A. Fee for branch circuits nvrh APP _... :: a b o ve s ervice (S feeder fee 6.65 ' ❑ APPLICANT C� !a3V ON : , :,, '; _ w• . _ each branch circuit Business name: circuits .._.,...- wirhoui service circuit e or feeder ice. 46,X5 T� g 2 E3. Fcc for brans Contact name Each add'I bran . ,.. I 1 trrrhonl servo •-'- S v ch cltc'uit Address hlls eeltaueons (service or feeder not included) ' ., City/State /ZIP: _ Each manufactured or modulair (50.90 ' ' 2 ' .. , - -- ..._ dwelling, service and /or tcedei ,,,.._ Phone: ( ) Fax:: ( ) Reconnect only 66.85 2 . -..,_ . ..__ • . Pump or irrigation circle ,3, 40 E-mail • -- — .. Si ne lig)ntln� ~3.40 — CONTRr#4 rOa ...,. _ Signal or circu or limitc(i • Business name: C,-,_. _ t_ 4s �• . t t. C C_ energy panel, alteration, or ■ extension. Describe. I' a!2, • 2 I 2 c Address: U . ri..- t1�(.. —_.._ __ - - -- CI P:ac odrlit iooal ,nspect over ; r ll ossa bl e t o any of the aii _� City/State/ZIP. Y - • -. Per r11611ection - 6- ;0 ,. Fax: ( lnvcstigsIion per flour I I b: ,,un I , 67. 5l1 - -- --- _— _ . - -,. -- • I 7:1.15 — .— ,_.,,. ndu. hotu 11.lecuicall,ic., - Z(_ u 2lZ 3 t.EC:r S J 1 is l ,tnai pl,mt pc CCB Lie.: t A l _ _ � Suprv. Electrician ; f tic" (juin-u'. 7� . t,_,.31.--- r� .,.. .. —.. __. r s x. L. , — H: ttYf 1;1 1c[ � , Suntcnat. S3 " • - •• - ` Date:: Print name —. / l'ito; i no sec name iv ( } +� — -. S i .,., ` — ) N l 0i-t - -- .. - a1c Ire h.lnu t i , ut p,;r lecl' r j ►'r _ b • Awl-girl/ iLil;uur ^° _- — ..._... ._... n i 9 i I' KMi l Lx ,. 4.�^•- �. 7^ _ —_. 1 per up {r i r p rr. 11 a prrutit i+ mil tlhtain w ithi n Sit 5 ' Print -- DikkQ! an,. „ fret. , h.r. ln....trrCI,N11 , 'simple naitl,, : \ nl O �l- 7H t 'C' L 4 ) C,� /L( f C• -. _. . — — ._ — Nw . l i . ..t n, ur r, I ,tiui1J11u I ; 1 , , , , ; , ; i, ,I,•. . Ed WUE0:80 600E 02 'unr £17SS99E21S : '0N BNOHd ONI OId1021d )SBNUO : WOdd